Prognostic value of "monosomal karyotype" in comparison to "complex aberrant karyotype" in acute myeloid leukemia: study on 824 cases with aberrant karyotype
Menée sur 824 patients atteints d'une leucémie myéloïde aiguë et présentant des anomalies cytogénétiques, cette étude compare la valeur pronostique d'un caryotype complexe (présence de plus de 3 anomalies) et d'une monosomie
In acute myeloid leukemia (AML) the subset with complex karyotype (CK) is traditionally regarded as the worst prognostic group. However, ≥3, ≥4 or ≥5 abnormalities have been variably used for its definition. Recently, "monosomal karyotype" (MSK) was suggested to indicate an even inferior outcome. We tested which definition fits best to identify the most unfavorable subgroup. After excluding patients with t(15;17)/PML-RARA, t(8;21)/RUNX1-RUNX1T1, inv(16)/t(16;16)/CBFB-MYH11 and normal karyotype 824 AML patients with cytogenetic abnormalities were analyzed. Patients with MSK or CK defined as ≥3, ≥4 or ≥5 abnormalities showed an inferior OS compared to the respective remaining patients not fulfilling these criteria (for all p<0.001). Hazard ratios were 1.93, 1.68, 1.94, and 1.92. CK≥4 as a single parameter identified the largest proportion of patients with very poor risk. However, combining CK≥4 and MSK detected an even larger number of patients with very unfavorable outcome (261/824, 31.7%).
Blood , résumé, 2011